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- Title
Is there an anti-androgen withdrawal syndrome for enzalutamide?
- Authors
Klot, Christoph; Kramer, Mario; Böker, Alena; Herrmann, Thomas; Peters, Inga; Kuczyk, Markus; Ligges, Uwe; Gschwend, Jürgen; Retz, Margitta; Schmid, Sebastian; Stenzl, Arnulf; Schwentner, Christian; Todenhöfer, Tilmann; Stöckle, Michael; Ohlmann, Carsten-Henning; Azone, Ines; Mager, René; Bartsch, Georg; Haferkamp, Axel; Heidenreich, Axel
- Abstract
Background: The anti-androgen withdrawal syndrome (AAWS) can be seen in one-third of patients after discontinuation of first-generation non-steroidal anti-androgen therapy. With the introduction of new agents for anti-androgen therapy as well as alternate mechanisms of action, new therapeutic options before and after docetaxel chemotherapy have arisen (Ohlmann et al. in World J Urol 30(4):495-503, ). The question regarding the occurrence of an enzalutamide withdrawal syndrome (EWS) has not been evaluated yet. In this study, we assess prostate-specific antigen (PSA) response after discontinuation of enzalutamide. Methods: In total 31 patients with metastatic castration-resistant prostate cancer (mCRPC) underwent an enzalutamide withdrawal and were evaluated. Data were gathered from 6 centres in Germany. Patients with continuous oral administration of enzalutamide with rising serum PSA levels were evaluated, starting from enzalutamide withdrawal until subsequent therapy was initiated, follow-up ended or death of the patient occurred. Statistical evaluation was performed applying one-sided binomial testing using R-statistical software, version 3.0.1. Results: Mean withdrawal follow-up was 6.5 weeks (range 1-26.1 weeks). None of the 31 patients showed a PSA decline. Mean relative PSA rise over all patients was 73.9 % (range 0.5-440.7 %) with a median of 44.9 %. Conclusions: If existent, an AAWS is at least very rare for enzalutamide in patients with mCRPC after taxane-based chemotherapy and does not play a clinical role in this setting. This may be attributed to the different pharmacodynamics of enzalutamide. Longer duration of therapy or a longer withdrawal interval may reveal a rare EWS in the future.
- Subjects
PROSTATE cancer treatment; ANTIANDROGENS; PROSTATE-specific antigen; DOCETAXEL; CANCER chemotherapy; DRUG administration; FOLLOW-up studies (Medicine); BIOCHEMICAL mechanism of action; THERAPEUTICS
- Publication
World Journal of Urology, 2014, Vol 32, Issue 5, p1171
- ISSN
0724-4983
- Publication type
Article
- DOI
10.1007/s00345-014-1288-3